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Lisfranc fracture, Myerson type A

Diagnosis certain

Presentation

Acute pain after the patient stepped on a slippery step and his left foot became trapped between the steps. He lost his balance, slipped and fell.

Patient Data

Age: 35 years
Gender: Male

Preoperative x-ray study

x-ray

Homolateral and lateral dislocation / displacement of the tarsometatarsal joints of left foot, highly suggestive of Myerson type A (lateral). The diastasis between the first and second metatarsal bases is less than 5 mm, suggesting Nunley-Vertullo grade 2.

Postoperative x-ray study

x-ray

2 months after surgery.

Case Discussion

Lisfranc injury is a broad term, that may refer from a low-energy sports trauma to a high-energy trauma. It is not a very frequent fracture and sometimes its radiological signs are so subtle that they can easily go unnoticed.

Contributed by Dr. Guilherme Pioli Resende M.D. and Dr. Arthemizio Antônio Lopes Rocha M.D.

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